Differences between panic attacks and autistic meltdowns

Panic attacks and autistic meltdowns are both common but happen for different reasons. Panic attacks are a symptom of anxiety that bring on sudden intense fear or discomfort. Autistic meltdowns, on the other hand, are a response to sensory or emotional overload. Anxiety disorders — which include panic disorder — affect up to 60% of autistic people, making anxiety more common in this group than in the general population.

Being able to tell the difference between these two experiences is important because they need different responses. Panic attacks improve with grounding techniques, reassurance, and therapy to manage anxiety. And autistic meltdowns require reducing sensory input and creating a calm, safe space. 

Can autism cause panic attacks?

Yes, autism can be linked to panic attacks, though it doesn’t directly cause them. Many autistic people struggle with unexpected changes or find social situations stressful, which can lead to overstimulation and trigger intense anxiety and panic. Difficulty recognizing emotions or body signals can also make it harder to catch early signs of anxiety in people with autism, which can lead to sudden panic attacks.

For someone with autism, panic attack symptoms may include:

• Feeling sensory overload that feels unbearable: Lights, sounds, or textures may suddenly become too much to handle.
• Shutting down or melting down: Instead of typical panic symptoms, you might freeze, stop talking, or have an emotional outburst.
• Reacting strongly to stress: You may feel an intense need to escape or find yourself reacting more than expected to stress, change, or uncertainty.
• Finding it hard to ask for help: You might struggle to explain what’s happening or what you need.

Knowing what triggers your panic attacks and how they affect you can make them feel less scary. Having a plan, a calming routine, and support can help you feel more in control. With the right tools, you can manage these moments more easily.

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Recognizing an autistic meltdown vs. a panic attack

Understanding the differences between a panic attack and an autistic meltdown is important for getting the right support, as they have different causes and symptoms. 

Autism spectrum disorder (ASD) is a neurodevelopmental condition that impacts how people communicate and interact with the world. And many autistic people may experience challenges with sensory input, emotional regulation, and social situations. These challenges can contribute to both panic attacks and meltdowns, making it essential to distinguish between them.

To better understand these differences, we’ll break down the main characteristics of panic attacks and autistic meltdowns below.

Panic attacks:

• Involve sudden feelings of intense fear or discomfort
• Can happen without a clear reason
• Are often linked to anxiety
• May include physical symptoms, like a racing heart, shortness of breath, or sweating

Autistic meltdowns:

• Usually occur in response to feeling overwhelmed by sensory or emotional input
• Can involve emotional outbursts, freezing, autistic shutdown, or difficulty communicating
• Are often triggered by specific situations or sensory overload
• May not have obvious physical symptoms like a panic attack

Panic attacks and meltdowns can appear differently in children and adults with autism. Children may cry, cling to caregivers, or throw tantrums during panic attacks, often feeling confused. Adults can describe their fear and physical symptoms more clearly. 

While children may scream or shut down during meltdowns, adults might withdraw or have emotional outbursts. Understanding these differences is important for providing the right support.

Managing autism and panic attacks together

Coping with panic attacks and autistic meltdowns can feel overwhelming, but the right strategies can make a big difference. While they may look similar on the surface, they have different triggers and require different approaches.

Managing an autistic meltdown

Autistic meltdowns happen when you become overwhelmed by sensory input, emotions, or stress. Unlike panic attacks, meltdowns aren’t caused by fear. Here’s how you can manage them:

• Reduce sensory input. If possible, move to a quiet, dimly lit space, or use tools like noise-canceling headphones or weighted blankets to help regulate your nervous system.
• Give yourself space. It’s OK to step away from overwhelming situations until you feel calmer.
• Use self-soothing techniques. Stimming (like rocking or using fidget tools) can help you regulate your emotions. If stimming helps you calm down, allow yourself to do it without judgment.
• Plan for recovery. After a meltdown, you might feel drained or exhausted. Give yourself time to rest and engage in comforting activities, like listening to music, taking a warm shower, or wrapping yourself in a blanket.

Managing a panic attack

Panic attacks come from intense fear and anxiety, often without an immediate external cause. Unlike meltdowns, they involve a sudden surge of panic and physical symptoms like a racing heart or dizziness. Here’s how you can manage them:

• Ground yourself in the present. Use grounding techniques — like the 5-4-3-2-1 method (naming things you can see, hear, touch, smell, and taste) — to reconnect with your surroundings.
• Control your breathing. Slow, deep breaths can help reduce the feeling of panic. Try inhaling for four counts, holding for four, and exhaling for four.
• Challenge anxious thoughts. Remind yourself that panic attacks are temporary and will pass. Anxiety might tell you something bad is happening, but your body is just reacting to stress.
• Move your body. Shaking out your hands, walking, or stretching can help release built-up tension and reduce panic.

Professional support

Seeking professional support can provide structure, guidance, and coping tools for both autistic meltdowns and panic attacks. Some helpful options include:

• Talk therapy: A mental health professional can help you develop personalized coping strategies. Cognitive behavioral therapy (CBT) can be effective for managing both autism and panic attacks. But other approaches — like dialectical behavior therapy (DBT) or acceptance and commitment therapy (ACT) — can also be beneficial.
• Occupational therapy: For autistic people, an occupational therapist can help create sensory-friendly strategies to prevent or manage meltdowns.
• Support groups: Connecting with others who have similar experiences can reduce isolation and provide a space to share coping strategies.
• Medication: Some people find relief through medication, whether for anxiety, sensory regulation, or both. A healthcare provider can help determine if this is the right option for you based on your unique needs.

Recovery doesn’t mean meltdowns or panic attacks will never happen again. Rather, it means you’ll have better ways to manage them. With time, you can learn to spot early signs, adjust your environment, and use coping strategies to feel more in control. 

Support from therapists, occupational therapy, or medication can help you navigate these challenges. The goal is to build a life where you feel supported, understood, and confident in handling stress.

Find care with Rula

Getting the right professional support can make a big difference in managing both panic attacks and autistic meltdowns. Therapy can provide tools to help you navigate anxiety, regulate your emotions, and develop coping strategies tailored to your needs. A mental health therapist can help you create a plan that reduces overwhelm and builds confidence. You don’t have to manage these challenges alone. Support is available, and the right guidance can help you feel more in control.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

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